Spontaneous Normalization of Valve Function After Failed Fibrinolytic Therapy for Left-Sided Prosthetic Valve Thrombosis

[...]residual valve dysfunction after FT normalizes spontaneously in nearly one-half the patients, but the risk of major adverse events is prohibitively high, particularly among patients who do not show improvement in functional class after FT. [...]these patients should be triaged for early redo surgery irrespective of the reduction in transvalvular gradients. Pre- and post-treatment mitral EDG, mm Hg 14.3, 6.2[dagger] Pre- and post-treatment mitral MDG, mm Hg 25.5, 12[double dagger] Pre- and post-treatment aortic PSG, mm Hg 66.5, 39.5§ Pre- and post-treatment aortic MSG, mm Hg 38.2, 22.6|| Complete failure 18 (58.1) Partial response 13 (41.9) Table 1 Baseline Characteristics and Response to Fibrinolytic Therapy (N = 31) Values are mean ± SD, n (%), or median (IQR).EDG = end-diastolic gradient; INR = international normalized ratio; MDG = mean diastolic gradient; MSG = mean systolic gradient; NYHA = New York Heart Association; PSG = peak systolic gradient.